TUBERCULIN SKIN TESTING IN HEALTH CARE WORKERS
Dr.T.V.Rao MD It was interesting to listen to Dr Chug MD one of the living legend in Microbiology on tuberculosis at Care Hospital Hyderabad, his work proves that the Health care workers at least a few of them succumb to tuberculosis and even the incidence rate of tuberculosis is higher in family members, Yet we have not mandatory recommendation how we care our Health care professionals, with progress of time many Doctors practicing in clinical care too get infected, however much under reported to health records fearing losing the confidence of the public and patients
UTILITY OF TUBERCILIN SKIN TESTING - We have certainly underutilized to Skin testing for tuberculosis at our Hospitals. Skin testing in Tuberculosis is one of the oldest testing method to evaluated for the infection with tuberculosis A tuberculin skin test (also called a Mantoux tuberculin test) is done to see if one is being exposed to tuberculosis (TB). The TB antigens used in a tuberculin skin test are called purified protein derivative (PPD). A measured amount of PPD (5 units to 10 units) and is injected with tuberculin syringe under the epidermal layer of skin on your forearm. Periodic testing of health care workers is recommended as part of a TB Infection Control Plan, and may be required by state regulations. and hospital policies This is a good test for finding a TB infection. It is often used when symptoms, screening, or testing, such as a chest X-ray, show that a person may have TB. a strong tuberculin test certainly supports the presence of tuberculous bacilli and its reactivity with immune repose
TESTING TO NEEDED AS FOLLOWING PROTOCLS
There are two types of testing for TB in health care workers.
Initial baseline testing upon hire: Two-step testing with a TB skin test
Annual or serial screening: determined by state regulations or risk assessment outcomes.
Baseline Testing: Two-Step Test
Two-step testing with the Mantoux tuberculin skin test (TST) should be used for baseline or initial testing. Some people with latent TB infection have a negative reaction when tested years after being infected. The first TST may stimulate or boost a reaction. Positive reactions to subsequent TSTs could be misinterpreted as a recent infection. And people to be watched for active infection with tuberculosis in future
Step 1
Administer first TST following proper protocol
Review result
Positive — consider TB infected, no second TST needed; evaluate for TB disease.
Negative — a second TST is needed. Retest in 1–3 weeks after first TST result is read.
Document result
Step 2
Administer second TST 1-3 weeks after first test
Review results
Positive — consider TB infected and evaluate for TB disease.
Negative — consider person not infected.
Document result
Improper Tuberculin skin testing -Administer the TB skin test following proper protocol In many hospitals the matter of testing Tuberculin is left to student nurses and untrained staff, never to forget the best results will be possible only with injecting the material as intradermal injection going deeper will lose the validity of test as the material is deposited in the fatty layer, and certainly the test will be negative in actively infected people, Injecting tuberculin is a skill the professionals should practice to perfection
TURNING FROM NEGATIVE TO POSITVE HAS A SUPPORTING VALUE IN DIAGNOSIS IN CASES PULONARY AND ETRA PULMONARY TUBERCULOIS
Review result — a change from a prior negative test result to a positive test result is evidence of recent TB infection
Document the Results in proper fashion
TODAY MANY HOSPITALS ARE ASKING FOR STATUS OF HBV AND HIV WHEN TAKING UP EMPLOYMENT WITH OR WITHOUT REASON
EVALUATION ON TUBERCULOSIS CARRIES MUCH IMPORTANCE AS TB IS TOTALLY CURABLE DISEASE Ref - Testing Health Care Workers Tuberculosis CDC
Formulated by Dr.T.V.Rao. MD for Medical and paramedical professionals in Euro vision to Health
Dr.T.V.Rao MD It was interesting to listen to Dr Chug MD one of the living legend in Microbiology on tuberculosis at Care Hospital Hyderabad, his work proves that the Health care workers at least a few of them succumb to tuberculosis and even the incidence rate of tuberculosis is higher in family members, Yet we have not mandatory recommendation how we care our Health care professionals, with progress of time many Doctors practicing in clinical care too get infected, however much under reported to health records fearing losing the confidence of the public and patients
UTILITY OF TUBERCILIN SKIN TESTING - We have certainly underutilized to Skin testing for tuberculosis at our Hospitals. Skin testing in Tuberculosis is one of the oldest testing method to evaluated for the infection with tuberculosis A tuberculin skin test (also called a Mantoux tuberculin test) is done to see if one is being exposed to tuberculosis (TB). The TB antigens used in a tuberculin skin test are called purified protein derivative (PPD). A measured amount of PPD (5 units to 10 units) and is injected with tuberculin syringe under the epidermal layer of skin on your forearm. Periodic testing of health care workers is recommended as part of a TB Infection Control Plan, and may be required by state regulations. and hospital policies This is a good test for finding a TB infection. It is often used when symptoms, screening, or testing, such as a chest X-ray, show that a person may have TB. a strong tuberculin test certainly supports the presence of tuberculous bacilli and its reactivity with immune repose
TESTING TO NEEDED AS FOLLOWING PROTOCLS
There are two types of testing for TB in health care workers.
Initial baseline testing upon hire: Two-step testing with a TB skin test
Annual or serial screening: determined by state regulations or risk assessment outcomes.
Baseline Testing: Two-Step Test
Two-step testing with the Mantoux tuberculin skin test (TST) should be used for baseline or initial testing. Some people with latent TB infection have a negative reaction when tested years after being infected. The first TST may stimulate or boost a reaction. Positive reactions to subsequent TSTs could be misinterpreted as a recent infection. And people to be watched for active infection with tuberculosis in future
Step 1
Administer first TST following proper protocol
Review result
Positive — consider TB infected, no second TST needed; evaluate for TB disease.
Negative — a second TST is needed. Retest in 1–3 weeks after first TST result is read.
Document result
Step 2
Administer second TST 1-3 weeks after first test
Review results
Positive — consider TB infected and evaluate for TB disease.
Negative — consider person not infected.
Document result
Improper Tuberculin skin testing -Administer the TB skin test following proper protocol In many hospitals the matter of testing Tuberculin is left to student nurses and untrained staff, never to forget the best results will be possible only with injecting the material as intradermal injection going deeper will lose the validity of test as the material is deposited in the fatty layer, and certainly the test will be negative in actively infected people, Injecting tuberculin is a skill the professionals should practice to perfection
TURNING FROM NEGATIVE TO POSITVE HAS A SUPPORTING VALUE IN DIAGNOSIS IN CASES PULONARY AND ETRA PULMONARY TUBERCULOIS
Review result — a change from a prior negative test result to a positive test result is evidence of recent TB infection
Document the Results in proper fashion
TODAY MANY HOSPITALS ARE ASKING FOR STATUS OF HBV AND HIV WHEN TAKING UP EMPLOYMENT WITH OR WITHOUT REASON
EVALUATION ON TUBERCULOSIS CARRIES MUCH IMPORTANCE AS TB IS TOTALLY CURABLE DISEASE Ref - Testing Health Care Workers Tuberculosis CDC
Formulated by Dr.T.V.Rao. MD for Medical and paramedical professionals in Euro vision to Health
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